Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Objectives: We sought to determine whether atorvastatin administration attenuates the inflammatory response and improves clinical outcomes in acute influenza. 
Methods: We conducted a randomized double-blind trial administering atorvastatin 40 milligrams or placebo to adults with confirmed influenza for five days between December 2013–May 2018. Patients were primarily enrolled in the emergency department (ED) at an urban, tertiary-care center. Serum was obtained at enrollment and 72 hours for the primary outcome, change in interleukin (IL-6). Patients reported severity of influenza symptoms over 10 days. We used linear mixed-effects models for the primary comparisons. 

Results: Of the 116 enrolled patients, 59 received atorvastatin and 57 received placebo. Groups were well-matched including baseline influenza symptom scores and receipt of an antiviral medication. There was no difference between groups in the change in interleukin-6 (IL-6) levels (P=0.468). However, there were significant differences in the overall influenza symptom scores, favoring faster resolution in the atorvastatin group (P=0.05). For patients presenting within 48 hours of symptom onset, resolution was faster for the overall score (P <0.001) and for the fever (P=0.001), sore throat (P=0.005) and headache (P=0.006) components. No safety concerns were identified. 

Conclusion: Atorvastatin administration in acute influenza appears safe. We did not find attenuation of IL-6 with atorvastatin. Patients receiving atorvastatin reported improvement in their clinical symptoms at a faster rate than those in the placebo group, particularly in patients presenting within 48 hours of symptom onset. This trial is registered at ClinicalTrials.gov, Identifier: NCT02056340.